胸腔镜临床检查应用

目的：探讨内科胸腔镜检查对疑难胸膜疾病的诊断检查和胸腔镜检操作关键。方法：回顾性分析91例内科胸腔镜检查诊断胸膜疾病的病例资料，总结病因组成和并发症。结果91例胸膜疾病患者，男性73例，女性18例，胸腔积液71例，自发性气胸20例。胸腔积液病因：恶性肿瘤39例，结核15例，慢性炎症14例；气胸病因：肺大疱6例；胸膜粘连3例；肺破裂1例；无原因者8例。并发症以发热多见，无与胸腔镜检查相关的死亡。结论：该院胸腔镜诊断的胸腔积液以恶性肿瘤最常见，其次为结核。难治性气胸首要病因为肺大疱。对胸液分析、细胞学检查和闭式胸膜活检不能确诊的胸膜疾病有必要考虑内科胸腔镜检查。

Medical thoracoscopy in the diagnosis of pleural disease

Objective: To evaluate the role of medical thoracoscopies in the diagnosis of pleural disease and to analyze tbe key to manipulating medical thoracoscopies.Methods:We retrospectively analyzed Ninty-one patients with pleural disease diagnosed by medical thoracoscopy were retrospectively analyzed in Guangdong Provincial People's Hospital. The results of these studies were conduded, including the pathologic results and the complications. Results: A total of 91 cases ( male 73, female 18; pleural effusion 71, pneumothorax 20) of pleural diseases were enrolled in the analysis. Pleural metastatic carcinoma was the most common cause which was responsible for 45.1% of the effusions; and followed by tuberculosis and chronic inflammation, which accounted for 21.1% and 19.7% of the effusions, respectively. The most common cause of pneumothorax was bullae,responsible for 35%. The most common complication was fever and there was no record of death related to thoracoscopy. Conclusions:Malignant tumer was the most common cause for diagnosed pleural effusion.And bullae was the most common cause for pneumothorax. As a minimally invasive technique, Medical thoracoscopy should be taken into consideration when routine fluid analysis, cytology and closed pleural biopsy failed to establish a diagnosis.